| NPI | 1972121432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 26343) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA 61078086) |
| Enumeration Date | 2020-07-10 |
| Last Update Date | 2025-03-12 |